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ABORTION AND CONSCIENCE

Religious freedom, I argued in my Notes on Religious Freedom, is not a special kind of liberty but one of a broader set of freedoms of conscience, belief, assembly and action. Whatever one’s beliefs, secular or religious, there should be complete freedom to express them, short of inciting violence or other forms of physical harm to others. Whatever one’s beliefs, secular or religious, there should be freedom to assemble to promote them. And whatever one’s beliefs, secular or religious, there should be freedom to act upon those beliefs, so long as in so doing one neither physically harms another individual without their consent, nor transgresses that individual’s rights in the public sphere. These, I argued, should be the fundamental principles by which we judge the permissibility of any belief or act, whether religious or secular.

It is true that many religious beliefs – about homosexuality, for instance, or blasphemy – imply practices that are often at odds with the norms of a liberal society, and this has been at the heart of many recent conflicts between secular norms and religious conscience. But such conflicts are not unique to religious belief. Racists, communists, Greens, New Age mystics – all could claim that their beliefs enforce upon them certain actions or practices which are at odds with liberal norms. Nevertheless, a racist pub owner cannot bar black people from his pub, however deep-set his beliefs. It would be a criminal offence for Greens to destroy a farmer’s field of legally grown GM crops, however strongly they might feel about such agriculture. Society should accommodate as far as is possible any action genuinely required by conscience. Nevertheless, there is always a line that cannot legally be crossed even if conscience requires one to. That line, I suggested in my Notes on Religious Freedom, should be in the same place for religious believers as for non-believers.

A marriage registrar should not have the right to pick and choose whom he or she is willing to marry. So long as a couple have a legal right to get hitched, a registrar should be obliged to perform the ceremony. A Christian marriage registrar should expect to have to perform gay civil partnerships, whatever their religious beliefs. Similarly, we should not accommodate the conscience of a Creationist biology teacher by allowing him or her not to teach the theory of evolution. But, I added, ‘we should not expect a doctor or a nurse, even in principle, to perform an abortion, if they feel to do so is against their beliefs. Whatever we may think of the belief that life begins at conception, it would be unreasonable in the extreme to expect those who do hold that belief to commit what they consider to be murder.’

This argument about ‘exemptions’ for doctors drew some criticism in the debate about my essay on Jerry Coyne’s blog Why Evolution Is True. As one commenter put it in the thread:

I’m not seeing what the ‘fundamental difference’ is between a doctor who believes that abortion is murder, and a teacher who believes that evolution means damnation for his students. The teacher’s horror at being forced to do such a thing is just as real (and just as irrational) as the doctor’s. But you’re willing to ignore that and demand compliance from the teacher that you do not demand from the doctor. Understand that I’m not defending the teaching of creationism. I’m wondering why you think the doctor merits a free pass for his irrational beliefs when the teacher plainly doesn’t.

I find it extraordinary that anyone cannot, almost instinctively, see the distinction between the insistence that children should be taught scientific truth and the acknowledgement that people should not forced to commit what they consider to be murder. Be that as it may, here are (slightly edited) the three points I made on the WEIT thread on the difference between refusing to teach evolution and refusing to perform abortions, and on why we should tolerate one but not the other:

First, evolution is a fact. Certainly, there are some who do not accept it as a fact. But that does not make it any less of a fact. There is no moral issue in insisting that children receiving state-sanctioned education should be taught the facts of evolution. Indeed it would be immoral to suggest otherwise.

Abortion is not a fact. It is an act, the rights and wrongs of which can be complex. Even atheists are deeply divided as to why we should support abortion, to what degree, and what the consequences are of doing so.

Peter Singer and I, for instance, both support abortion. There are few facts about which we would disagree. Yet we differ profoundly about why we support abortion, a difference that arises from holding fundamentally different views about the character of human life, the meaning of morality, the means by which we evaluate norms, etc. I defend abortion on the basis of rights and choice, Singer does so from a utilitarian perspective. This leads him to support ‘post-birth’ abortion – that is, infanticide – and to suggest that animals that possess greater cognitive abilities than young children possess also a greater claim to life. I profoundly disagree on both points.

This is not the place to debate my differences with Singer and the utilitarian approach to abortion (I have done so elsewhere). All I am trying to point out is that even atheists as strongly in favour of abortion as Singer and I are can also be profoundly divided on the issue. Singer and I can have – indeed have had – a rational debate about this. But it is not a debate that can be settled simply by appealing to facts because it depends partly upon the philosophical and moral framework within which we fit those facts.

There are deep debates, too, even among non-believers, as to when abortion should apply. Should the limit be set at 18 weeks? 24 weeks? Birth? Post-birth? There are many doctors (both religious and non-religious) who support a woman’s right to choose but who would not wish to perform an abortion themselves. As someone who believes in abortion on demand, I oppose the current attempts to restrict abortions. I certainly campaign for and defend a woman’s right to choose. But the very fact that we have this debate reveals the complexities and dilemmas surrounding the question of abortion. The debate about abortion, in other words, is not merely one of facts, as is the debate about evolution; it is one that touches on profound questions of what we think it means to be human, and of how we define morality.

Second, a biology teacher who rejects evolution is a poor teacher. As the great biologist Theodosius Dobzhansky put it, ‘nothing in biology makes sense except in the light of evolution’. That might be an exaggeration, but understanding evolution certainly lies at the heart of understanding the science of life. To insist that a biology teacher teach evolution is simply to insist that he or she be a biology teacher. A doctor who objects to abortion, on the other hand, is not necessarily a poor doctor. In fact there are many exceptional doctors who oppose abortion. It is not the case that ‘nothing in neurosurgery or oncology makes sense except in the light of support for abortion’.

Third, to force someone to commit what they consider to be murder (even if I do not consider it so) seems to me deeply immoral. Again, this is not an issue simply of religious belief. It is not different in principle, for instance, from accepting that people may have ‘conscientious objections’ to war. I am no pacifist, but I accept that there are people, both religious and non-religious, who have moral objections to killing other human beings in conflict. I disagree with their argument, but I also accept that it is legitimate to hold that moral view.

Similarly, I accept the case for assisted dying. But I do not, for a moment, think that this should require doctors to participate, only that it should allow them to do so.

There are not many, I would imagine, who would fail to understand why it is wrong to force a doctor to commit what he or she thinks is murder. The kind of moral blindness exhibited in this view is, however, an extreme version of an approach that is increasingly finding purchase. There is a growing tendency in certain atheist/rationalist circles to think of morality in terms of abstract logic rather than in terms of the rationality of human life as it is actually lived. A Martian, with no understanding of human emotions, or of human concepts of life and death, etc, may well view opposition to Darwinism and opposition to performing an abortion as equivalent expressions of conscience. As Earthlings, we should not.

I am as in favour of a woman’s right to abortion as I am hostile to Creationism. I recognize, however, a fundamental difference between insisting that all biology teachers teach the theory of evolution and forcing a doctor to perform an abortion against his or her will. I recognize, too, a fundamental difference between defending a woman’s right to choose and insisting that this includes the right to compel a doctor to perform an abortion. Not to recognise such distinctions is to distort the very idea of morality.

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6 comments

KM is right that a doctor refusing to perform an abortion out of concience is has a stronger case than a racist pub owner. Though I think even that bloke can have his pub, and if he doesn’t want my custom, then I don’t want his beer.

Both KM and his opponents have an unarticulated belief that if you nominally belong to XYZ proffession then you must do everything that XYZists are thought to do (e.g. sell beer to the public or perform abortions). KM then wants to exempt conciencous objectors from that obligation.

KM’s opponents seem to think that either there should be no such exception or else they claim the right to decide what people are allowed to be conciencous about. Absurd as that second idea is, it is what follows from assuming that doctors and publicans are automatically obliged to do certain things.

In fact there is no such general obligation – not a legal one anyway. Particular arguments might be made for particular obligations: for example becoming a science teacher obliges you to teach the important bits of science; but the presumption should be that proffessionals are as free as anyone else.

Of course there seems to be a big difference between the doctor and the pub-owner. A pub-owners product is hospitality and selling drinks and foods and a pub is a public place. If I adhere to his house rules and pay my bill, there is no reason he could refuse me his hospitality, it is as simple as that. A doctor has a similar position towards his patients. If the patient pays his bill he cannot refuse medical services on grounds of skin-colour.

What Kenan Malik is stating here that there are cases where society demands you to act against your beliefs and moral standards and cases where this is allowed. This a very peculiar distinction. If you apply the scientific standard (as in teaching evolution) you can safely state that as long as an embryo has no neural system a doctor is only removing a group of cells. It is in fact (excusez le comparison) similar to removing a tumour. The reason the doctor in Maliks view has a right to refuse is: his ‘belief’ that life is considered to be a gift of god and starts at conception. This is a belief and not a scientific fact.

Now the problem is clear: you are not allowed to act against your beliefs in the case of a pub-owner or a biology teacher, but you are in case god and the possibility of life is involved. To put it to the extreme in case the life of the mother is endangered the doctor has the right to let the mother die and the child live? In this case you may argue: is the doctor not acting against his own standard? Doesn’t he-or-she have the obligation to save the mothers life?

The three reasons Malik mentions do not hold:
Evolution is fact, but teaching evolution is also an act. And teaching children against your value system is extremely difficult, because inner conviction tells you that you are doing something wrong and you put these children on the wrong track. The fact that society thinks otherwise will not change the conviction or feeling.

The fact that a teacher that does not acknowledge evolution is a bad biology teacher is accepted but the same applies for a doctor who thinks that the clump of cells in the first weeks of conception are a life. He has at least a very poor understanding of what life entails and this makes it even worse: This doctor does not show empathy for his patient in distress. Keep in mind that a woman is not asking for abortion as a luxury. And this patient should be the primary concern of the medical profession. This takes away his second argument.

The only argument that remains requires a bit more explanation. In fact all human beings experience, we experience through our senses. These senses translate the signals from our outer world to our brain and there we store, remember and feel this world. And according to Maliks reasoning there a degrees of moral standards, as stated earlier. In the case of discrimination or teaching science the standards our liberal world force upon us are more important then our feelings and thus we are expected to act against it (in case we think that certain races are inferior or that evolution is not true, with both I do not agree). But when we think we kill another human being society cannot force us to act against our moral standards. The belief someone terminates human life (even if this is not the case as Malik acknowledges) is so sacred we do not have to act against it.

In fact he says: teaching evolution and discrimination are only minor violations of ones conviction and feelings but in the case of a major violation you are allowed to object. Now the jump from minor to major is utterly subjective. Teaching evolution can feel just as bad as abortion. A true Christian will be convinced that by teaching children this scientific fact and the possibility that they accept it paves the way to hell and eternal damnation. This is in fact even worse than killing, because the potential human will never sin and cannot not be punished. (Or you must have a very irrational set of beliefs). So by accepting this exception we are on the slippery slope.

My solution is pretty simple and I advocate it for marriage registrars that do not want to marry gay couples, for biology teachers that do not want to teach evolution and for pub-owners that want to discriminate, for soldiers that do not want to kill and for gynaecologists that do not want to perform abortion: choose another profession

‘If you apply the scientific standard (as in teaching evolution) you can safely state that as long as an embryo has no neural system a doctor is only removing a group of cells. It is in fact (excusez le comparison) similar to removing a tumour.’

In fact virtually all abortions take place on embryos with at least a primitive nervous system. The process of neuralisation begins in the third week and the rudiments of a nervous system are well in place by four weeks. So the claim that ‘as long as an embryo has no neural system a doctor is only removing a group of cells’ is true, but it is also irrelevant to the debate about abortion. The question is not ‘Does an embryo / fetus have a nervous system?’ It is, till what point in the development of an embryo/ nervous system is abortion acceptable?

The facts of embryonic development are not in dispute. The meaning of such development for what it is to be human, and how that relates to the question of abortion, is. That is why the division is not simply between those who are religious and those who secular. Religious believers are divided on the question of whether abortion is permissible and when. So are secular thinkers. Till when should abortion be permissible? Never? Till the embryo develops a nervous system? Till it develops a functioning nervous system? (Though that raises the question of how functioning such functioning needs to be.) Till it is capable of feeling pain? (Though there is great debate about exactly when this is.) Till it is viable? Till birth? Post-birth? All these answers have been given. One can have a rational debate about this. But it is not a debate that can be settled simply by pointing to the facts of embryonic development. If you want to see the issues raised by such a debate see my essay on the utilitarian argument for post-birth abortion, and also the comment thread that follows.

I could put the question another way. You think it morally permissible to force a doctor to perform an abortion even if they think that to do so is murder. To what stage would you wish to force a doctor to do this? Suppose a doctor accepts the case for abortion, but thinks that it is wrong to abort a fetus over 18 weeks. Should he or she be forced to, if the law says that it is permissible? Suppose he or she is willing to perform an abortion but not on a viable fetus. Should he or she be forced to? Should he or she be forced to abort until birth? What about ‘post-birth abortions’, ie infanticide, for which many utilitarians make an argument? And if you draw a line before post-birth abortions, why do you do so?

The fundamental confusion in your argument is between defending a woman’s right to choose (and, in my case, defending abortion on demand) and insisting that such a right includes the right to force a doctor to abort. These are separate questions. To insist on the first does not require one to insist on the second.

Is there really a disagreement here if you take into account the human impact of changing rules and norms?

The case of the fundamentalist Christian council registrar who was dismissed for refusing to conduct civil ceremonies for gay couples was a case in point. She’d been a registrar for, I recall, 20 years. Then the rules changed and, quite rightly, enabled gay couples to have civil ceremonies. From that point on, anyone who wants to become a registrar knows that they will be required to perform civil ceremonies (and hopefully gay marriages). If they don’t like it, they shouldn’t apply.
And if our Christian lady were the only registrar, then she would need either to leave, change jobs, or accept that her employer was required by law to provide the service so she had to do it.
But that wasn’t the position. There were other registrars. Surely the kind and compassionate approach would have been be to find a way to ensure that a good service was provided to gay couples but that they were done by other registrars, rather than end a career of 20 years (and provide grist to the mill of Lord Carey and others who like to claim that Christians are being “persecuted” in the UK).

Similarly, if I were a brilliant gynaecologist of 30 years standing who occasionally performed abortions up to x weeks but then the law changed in the Peter Singer direction to include infanticide, I would refuse to do it. Does that mean I should be sacked? Or should it mean that, from then on, that’s the deal for anyone new, but for those already in the profession, everything should be done to avoid losing their expertise, and causing them avoidable suffering, while adhering to the law.

Many of these conflicts would be better resolved through the pragmatic use of common sense than through the strict application of principle, particularly when those principles remain socially contested. A religious believer should not normally have the legal right to discriminate. But if it is possible to arrange matters so that a believer can act according to conscience without causing harm or discrimination to others, then it might be worthwhile doing so. In principle, a Christian marriage registrar should expect to have to perform gay civil partnerships, whatever their religious beliefs. However, it might make pragmatic sense to roster others to perform ceremonies for gay couples, not because we should accept prejudice – prejudice, whether religious or secular in form, should always be challenged – but in acknowledgement of the fact that genuine social conflict exists on this issue. We should not give an inch to bigotry. Someone whose ‘conscience’ would not allow them to work with gays, or to marry Jews, should clearly not be indulged. Nevertheless, many oppose gay partnerships or marriages as a matter of conscience and not simply through homophobia (albeit that ‘conscience’ can, of course, often be a cover for homophobia). We can both challenge such attitudes and accept that on matters of genuine conscience, a little leeway or accommodation that allows someone to live by their principles may be desirable. The law should not make any such accommodation. But as individuals, or as organizations, it may be wise to, though not at the cost of causing harm, allowing discrimination or endorsing bigotry.

My point about abortion was that even in principle we should not expect someone to commit what they consider to be murder:

A marriage registrar should be expected in principle, if not necessarily in practice, to perform gay civil partnerships. But we should not expect a doctor or a nurse, even in principle, to perform an abortion, if they feel to do so is against their beliefs. Whatever we may think of the belief that life begins at conception, it would be unreasonable in the extreme to expect those who do hold that belief to commit what they consider to be murder.

I find it awkward that there are always these two positions, either for (liberal, secular) or against (conservative, religious). Nothing else. No distinctions between different cases, no different abortions. No secular anti-abortion stance. If you support a woman’s right of choice, you do it in every situation? Why? Isn’t there a difference between a teenage pregnancy at 7 weeks and a pregnancy of a mother who just feels that a baby is not ok right now or just she doesn’t want more children – and has an abortion at 17+ weeks?

For example, here in Finland, one doctor recently told that many (middle-class) couples (who already have children) want abortion because they have so massive mortgages and want to maintain their standard of living. So the reason for abortion is a lack of money – here in our wealthy state, where family benefits etc. are the most generous ones in the world.

Is this as acceptable as any other “choice”? Isn’t this a bit of a societal question as well, if not political and economic? I don’t find it reasonable to talk about “abortion” like it was always the same. It is not only about gestational age; there are different elements we need to know and understand. My ethics, at least, uses these kinds of details.

Furthermore, in a similar vein, why are there so few babies with Down’s syndrome these days? Is it because of better scanning and science? More liberal atmosphere of making choices? Feminism? Our more and more demanding and competive life in general? Or, is it about moral degradation or a sort of ethical transformation?